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OBJECTIVE To explore the expression of SODD and bcl-2 proteins in bone marrow cells of children with acute leukemia (AL), and to examine the relationship of their expression with the classification, clinical features,therapeutic effect and prognosis for AL patients.METHODS Using the SABC immunohistochemical staining method, the expression of SODD and bcl-2 proteins in the bone marrow cells of 86 AL cases was determined. The patients were studied based on the following groups: 1) a first-visiting group; 2) a refractory-relapse group(some patients were sensitive to therapy but then suffered a recurrence);3) a complete-remission group (CR); 4) a high risk (HR) and 5) standard risk (SR) group; 6) a control group of patients with non-hematological diseases.RESULTS The positive rates of SODD and bcl-2 expression in the firstvisit, refractory-relapse and CR groups were significantly higher (P＜0.05)compared to the control group. There was no significant difference in the expression of SODD or bcl-2 proteins between an acute lymphoblastic leukemia (ALL) group and acute nonlymphoblastic leukemia (ANLL)group (t=1.874, t=1.583, P＞0.05). The positive rates of SODD and bcl-2expression in the patients who developed complete remission after chemotherapy were significantly lower (t=2.054, t=2.703, P＜0.05) compared to the first-visit pediatric patients. The expression of the SODD protein in the refractory-relapse group was notably higher compared to the group treated initially (t=-1.081, P＜0.05). A high expression of the bcl-2 protein was found in both the first-visit and refractory-relapse groups, with no significant difference found between the two groups (t=-1.196, P＞0.05), whereas the percentage of bcl-2 positive cells in the refractory-relapse group (45%～87%) was significantly higher compared to the first-visit group (5%～62%). The positive expression of the SODD and bcl-2 proteins in the high-risk (HR) group were both significantly higher than the SR group (t=-3.236, t=-3.555, P＜0.01). The Pearson rank correlation analysis indicated that there was a positive correlation between SODD and bcl-2 expressions (P＜0.01, r=0.726). Among the 30 AL patients in the initial treatment group, 13 patients showed negative SODD expression. These children reached a complete remission (CR) rate of 84.6% (11/13), while in the other 17 cases with positive SODD expression, the CR rate was 64.7% (11/17). In 8 patients with negative bcl-2 expression, the CR rate amounted to 100% (8/8), and in 22 cases with positive bcl-2 expression, the CR rate reached 63.6% (14/22). Statistical analysis showed that the CR rates in patients with negative expression of SODD and bcl-2 were all significantly higher (P＜0.05) compared to the patients with positive expression.CONCIUSION Both SODD and bcl-2 are closely related to the onset,progression, curative effect and prognosis of AL in children. The expression of SODD and bcl-2 has a definite synergistic relationship with the onset and development of AL.